Individual
MR. BEASLEY STEPHEN TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3505 OLD JACKSONVILLE RD, TYLER, TX 75701-8510
(903) 561-7835
Mailing address
3505 OLD JACKSONVILLE RD, TYLER, TX 75701-8510
(903) 561-7835
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
207862
TX
Other
Enumeration date
12/20/2007
Last updated
12/20/2007
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